对疑似肺栓塞的 covid-19 患者进行 ctpa 试验的好处

IF 1.3 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Medical Imaging and Radiation Sciences Pub Date : 2024-10-01 DOI:10.1016/j.jmir.2024.101511

Mr Muhammad Nazmi Zulkafli , Mrs Ann Erynna Lema Thomas Sudin , DR Noor Shafini Mohamad , DR Nazimah Ab Mumin , DR Roqiah Fatmawati Abdul Kadir , Miss Siti Hawa Mahfar

{"title":"对疑似肺栓塞的 covid-19 患者进行 ctpa 试验的好处","authors":"Mr Muhammad Nazmi Zulkafli , Mrs Ann Erynna Lema Thomas Sudin , DR Noor Shafini Mohamad , DR Nazimah Ab Mumin , DR Roqiah Fatmawati Abdul Kadir , Miss Siti Hawa Mahfar","doi":"10.1016/j.jmir.2024.101511","DOIUrl":null,"url":null,"abstract":"<div><h3>Background / Purpose</h3><div>This study aimed to investigate the effectiveness of the test-bolus technique application for Computed Tomography Pulmonary Angiography (CTPA) in COVID-19 patients by analyzing contrast media volume and radiation dose reduction, and image quality.</div></div><div><h3>Methods</h3><div>This is a retrospective study of 32 CTPA images from Hospital Al-Sultan Abdullah (HASA) (Group A) and University Malaya Medical Centre (Group B) with clinical suspicion for PE from 1<sup>st</sup> February 2021 to 1<sup>st</sup> May 2021. Group A (N=16) received test-bolus technique (35ml of 370mg/I at 5ml/s) and Group B (N=16) received bolus-tracking technique (50ml of 370mg/I at 5ml/s) and were scanned by 128-slice Siemens Somatom Definition AS (Siemens Healthcare, Forchheim, Germany) CT scan machine. For analysis, subjective image quality was done by two board-certified radiologists independently (both 7 years’ experience) using a 5-point Likert's scale at an axial image at the level of the pulmonary artery. Objective image quality analysis was done by measuring contrast enhancement at the MPA, RPA, LPA, left upper and lower lobe PA, apical segment artery and vein, basal segment artery and vein. The CTDI<sub>vol</sub>, dose-length product (DLP) and Effective dose (E) were measured. The volume of contrast media was recorded.</div></div><div><h3>Results</h3><div>Group A mean contrast volume was (38.13ml ± 2.5ml) compared to Group B (56.25ml ± 8.85ml), (<em>P</em><0.005), leading to a 32.21% contrast reduction (<em>p</em>=0.000). 8.8% of dose increase in mean CTDI<sub>vol</sub> in group A (16.45mGy±3.43mGy) compared to group B (15mGy ± 2.8mGy) (<em>p</em>=0.200). For mean DLP and effective dose, the dose increase was 9.2% in group A (204.38mGycm ± 47.42mGycm), (3.27mSv ± 0.76 mSv) compared to group B (185.56mGycm ± 16.97mGycm), (2.97mSv ± 0.27mSv), with <em>p</em>=0.152 each.</div></div><div><h3>Conclusion(s)</h3><div>This study proved that the test-bolus technique application is effective in reducing contrast media volume usage for CTPA in COVID-19 patients with suspected PE.</div></div>","PeriodicalId":46420,"journal":{"name":"Journal of Medical Imaging and Radiation Sciences","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Benefits of test-bolus technique for ctpa in covid-19 patients with suspected pulmonary embolism\",\"authors\":\"Mr Muhammad Nazmi Zulkafli , Mrs Ann Erynna Lema Thomas Sudin , DR Noor Shafini Mohamad , DR Nazimah Ab Mumin , DR Roqiah Fatmawati Abdul Kadir , Miss Siti Hawa Mahfar\",\"doi\":\"10.1016/j.jmir.2024.101511\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background / Purpose</h3><div>This study aimed to investigate the effectiveness of the test-bolus technique application for Computed Tomography Pulmonary Angiography (CTPA) in COVID-19 patients by analyzing contrast media volume and radiation dose reduction, and image quality.</div></div><div><h3>Methods</h3><div>This is a retrospective study of 32 CTPA images from Hospital Al-Sultan Abdullah (HASA) (Group A) and University Malaya Medical Centre (Group B) with clinical suspicion for PE from 1<sup>st</sup> February 2021 to 1<sup>st</sup> May 2021. Group A (N=16) received test-bolus technique (35ml of 370mg/I at 5ml/s) and Group B (N=16) received bolus-tracking technique (50ml of 370mg/I at 5ml/s) and were scanned by 128-slice Siemens Somatom Definition AS (Siemens Healthcare, Forchheim, Germany) CT scan machine. For analysis, subjective image quality was done by two board-certified radiologists independently (both 7 years’ experience) using a 5-point Likert's scale at an axial image at the level of the pulmonary artery. Objective image quality analysis was done by measuring contrast enhancement at the MPA, RPA, LPA, left upper and lower lobe PA, apical segment artery and vein, basal segment artery and vein. The CTDI<sub>vol</sub>, dose-length product (DLP) and Effective dose (E) were measured. The volume of contrast media was recorded.</div></div><div><h3>Results</h3><div>Group A mean contrast volume was (38.13ml ± 2.5ml) compared to Group B (56.25ml ± 8.85ml), (<em>P</em><0.005), leading to a 32.21% contrast reduction (<em>p</em>=0.000). 8.8% of dose increase in mean CTDI<sub>vol</sub> in group A (16.45mGy±3.43mGy) compared to group B (15mGy ± 2.8mGy) (<em>p</em>=0.200). For mean DLP and effective dose, the dose increase was 9.2% in group A (204.38mGycm ± 47.42mGycm), (3.27mSv ± 0.76 mSv) compared to group B (185.56mGycm ± 16.97mGycm), (2.97mSv ± 0.27mSv), with <em>p</em>=0.152 each.</div></div><div><h3>Conclusion(s)</h3><div>This study proved that the test-bolus technique application is effective in reducing contrast media volume usage for CTPA in COVID-19 patients with suspected PE.</div></div>\",\"PeriodicalId\":46420,\"journal\":{\"name\":\"Journal of Medical Imaging and Radiation Sciences\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Medical Imaging and Radiation Sciences\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S193986542400242X\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Medical Imaging and Radiation Sciences","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S193986542400242X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

摘要

背景/目的本研究旨在通过分析造影剂用量和辐射剂量的减少以及图像质量，探讨在COVID-19患者中应用测试栓技术进行计算机断层扫描肺血管造影（CTPA）的有效性。方法这是一项回顾性研究，研究对象为2021年2月1日至2021年5月1日期间，来自苏丹阿卜杜拉医院（HASA）（A组）和马来亚大学医疗中心（B组）的32张临床怀疑为PE的CTPA图像。A 组（16 人）接受测试栓塞技术（35 毫升 370 毫克/毫升，5 毫升/秒），B 组（16 人）接受栓塞跟踪技术（50 毫升 370 毫克/毫升，5 毫升/秒），并使用 128 排西门子 Somatom Definition AS（西门子医疗集团，德国福希海姆）CT 扫描仪进行扫描。主观图像质量分析由两名经委员会认证的放射科医生（均有 7 年经验）独立完成，在肺动脉水平的轴向图像上使用 5 点李克特量表。客观图像质量分析是通过测量 MPA、RPA、LPA、左上叶和左下叶 PA、心尖段动脉和静脉、基底段动脉和静脉的对比度增强来完成的。测量了 CTDIvol、剂量-长度乘积（DLP）和有效剂量（E）。结果 A 组的平均造影剂量为（38.13ml ± 2.5ml），B 组为（56.25ml ± 8.85ml）（P<0.005），造影剂量减少了 32.21%（P=0.000）。与 B 组（15mGy ± 2.8mGy）相比，A 组（16.45mGy±3.43mGy）的平均 CTDIvol 剂量增加了 8.8%（P=0.200）。就平均 DLP 和有效剂量而言，与 B 组（185.56mGycm ± 16.97mGycm）、（2.97mSv ± 0.27mSv）相比，A 组（204.38mGycm ± 47.42mGycm）、（3.27mSv ± 0.76mSv）的剂量增加了 9.2%，P=0.200。结论：本研究证明，在COVID-19疑似PE患者的CTPA中，应用试验-缓冲技术可有效减少造影剂用量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Benefits of test-bolus technique for ctpa in covid-19 patients with suspected pulmonary embolism

Background / Purpose

This study aimed to investigate the effectiveness of the test-bolus technique application for Computed Tomography Pulmonary Angiography (CTPA) in COVID-19 patients by analyzing contrast media volume and radiation dose reduction, and image quality.

Methods

This is a retrospective study of 32 CTPA images from Hospital Al-Sultan Abdullah (HASA) (Group A) and University Malaya Medical Centre (Group B) with clinical suspicion for PE from 1^st February 2021 to 1^st May 2021. Group A (N=16) received test-bolus technique (35ml of 370mg/I at 5ml/s) and Group B (N=16) received bolus-tracking technique (50ml of 370mg/I at 5ml/s) and were scanned by 128-slice Siemens Somatom Definition AS (Siemens Healthcare, Forchheim, Germany) CT scan machine. For analysis, subjective image quality was done by two board-certified radiologists independently (both 7 years’ experience) using a 5-point Likert's scale at an axial image at the level of the pulmonary artery. Objective image quality analysis was done by measuring contrast enhancement at the MPA, RPA, LPA, left upper and lower lobe PA, apical segment artery and vein, basal segment artery and vein. The CTDI_vol, dose-length product (DLP) and Effective dose (E) were measured. The volume of contrast media was recorded.

Results

Group A mean contrast volume was (38.13ml ± 2.5ml) compared to Group B (56.25ml ± 8.85ml), (P<0.005), leading to a 32.21% contrast reduction (p=0.000). 8.8% of dose increase in mean CTDI_vol in group A (16.45mGy±3.43mGy) compared to group B (15mGy ± 2.8mGy) (p=0.200). For mean DLP and effective dose, the dose increase was 9.2% in group A (204.38mGycm ± 47.42mGycm), (3.27mSv ± 0.76 mSv) compared to group B (185.56mGycm ± 16.97mGycm), (2.97mSv ± 0.27mSv), with p=0.152 each.

Conclusion(s)

This study proved that the test-bolus technique application is effective in reducing contrast media volume usage for CTPA in COVID-19 patients with suspected PE.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of Medical Imaging and Radiation Sciences RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

2.30

自引率

11.10%

发文量

231

审稿时长

53 days

期刊介绍： Journal of Medical Imaging and Radiation Sciences is the official peer-reviewed journal of the Canadian Association of Medical Radiation Technologists. This journal is published four times a year and is circulated to approximately 11,000 medical radiation technologists, libraries and radiology departments throughout Canada, the United States and overseas. The Journal publishes articles on recent research, new technology and techniques, professional practices, technologists viewpoints as well as relevant book reviews.